Fluid Balance Overview

Serum potassium level above 5.3 mEq/L, uncommon in healthy kidneys.

Increased total body potassium or intracellular potassium shift into the blood (e.g., tissue trauma, acidosis).

Potassium-based salt substitutes, supplements, potassium-sparing diuretics, kidney failure, uncontrolled diabetes.

Muscle twitching/cramps, weakness, diarrhea, low blood pressure, cardiac arrhythmias, or arrest.

Serum potassium level, ECG changes, serum pH.

Limit potassium intake, avoid supplements, potassium-losing diuretics, kayexalate, insulin with glucose.

Problems with blood calcium levels, primarily stored in bones and teeth.

8.2-10.2 mg/dL or 2.1-2.6 mmol/L.

Serum calcium level below 8.2 mg/dL or 2.1 mmol/L.

Body loses more calcium than it replaces from intestines or bones.

Postmenopausal women, lactose intolerance, adolescents, elderly, pregnant/lactating women, chronic diseases, inflammatory bowel disease, thyroid removal, hyperphosphatemia.

Mental status changes, hyperactive reflexes, diarrhea, cardiac arrhythmias, or arrest. (Trousseau sign: arm pressure test causing hand spasm).

Medications that block opioid receptors, reversing the effects of opioids.

Inactive substances used in research settings for comparison purposes, with prior informed consent.

Pain management strategies that do not involve medications, such as relaxation techniques or distraction.

Different ways to administer pain-relieving medications (drugs).

Methodical evaluation of pain using specific questions and scales to determine its location, intensity, and nature.

Strategies for pain management that focus on a combination of thoughts, feelings, and behaviors related to pain.

Medical devices specifically designed for managing pain, such as epidurals or PCA pumps.

Tasks performed by Licensed Practical Nurses (LPNs) in pain management, including monitoring devices and providing non-pharmacological care.

Surgical procedures performed with robotic arms controlled by a surgeon, used for cutting, suctioning, and suturing.

The three phases of surgery: preoperative, intraoperative, and postoperative.

The phase of surgery before the surgical procedure itself.

Planned preparation before surgery to optimize recovery and outcomes.

Conditions that increase the chance of complications during or after surgery.

Older patients may take longer to recover from anesthesia and surgery due to slower metabolic rates and decreased organ function.

Chronic diseases can increase surgical risks, requiring health clearance from the healthcare provider.

Patients' feelings and concerns related to surgery should be addressed, and extreme fear might require reevaluation or postponement.

Proper nutrition, including protein, vitamin C, and zinc, is crucial for healing after surgery. Assessing and correcting any nutritional deficiencies is important for faster recovery.

Obese patients might experience delayed wound healing.

Patients who are malnourished may experience infection or delayed wound healing.

Experiencing continuous distress, often associated with chronic pain, causing emotional and spiritual discomfort.

The patient remains in control of their own airway during procedures using sedation.

Patient cannot eat or drink anything for 6 hours before a procedure, clear liquids allowed up to 2 hours pre-procedure.

Persistent pain lasting for more than 3 months, affecting daily life.

Using faith, prayer, meditation, or self-reflection to address pain and suffering.

Patients are closely monitored every 15 minutes post-procedure for changes in vital signs, fluids, ambulation, and urination.

Patients are ready for discharge when vital signs are stable, fluids are retained, safe ambulation, and urination has occurred.

Uncontrolled chronic pain causes harmful substances released from the injured area, leading to tissue breakdown, a faster metabolism, weakened immune system and negative emotions.

Written and oral instructions are provided to patients and their companions before discharge, with signing needed for agreement.

Pain experiences and expressions can vary by culture and individuals.

The patient is central to pain management, with the healthcare team and regulatory bodies sharing the responsibility for effective treatment.

Safety is the priority, making sure the patient's airway remains clear and they don't fall.

Body's adaptation to opioids, leading to a need for more medication to achieve the same pain relief.

Patients cannot drive, operate machinery, or sign legal documents for 24 hours after a procedure.

A normal response to chronic opioid use, with potential withdrawal symptoms when stopped abruptly.

Patients are transferred from surgery at a normal body temperature.

Chronic brain disease impacting the ability to control drug use, leading to compulsive behaviors focused on obtaining relief.

Patients transitioning from general or spinal anesthesia will go to the PACU; while patients undergoing local anesthesia, will go directly to the nursing unit or recovery area.

The initiation of a pain stimulus and its conversion into an electrical signal at the point of injury.

The period starting when a patient enters the PACU or nursing unit, and ends with a follow-up appointment with the surgeon.

The transmission of pain signals from the peripheral nerves to the spinal cord and brain.

The actual feeling of pain, involving the hypothalamus, controlling emotions and reactions.

The body's attempt to lessen pain signals by releasing endorphins.

Chemicals that influence pain transmission and perception.

Pain caused by tissue damage.

Pain caused by nerve damage.

Pain felt in an area away from the source of the problem, like a heart attack causing pain in the arm.

Pain relievers.

Pain relievers that act on the brain to reduce pain perception.

Pain relievers that don't involve opioids such as NSAIDs.

Medications initially used for other conditions but also show pain-relieving properties.

Estimating the dosage of different pain medications to provide the same level of pain relief. Morphine is the standard for comparison, demonstrating how much other pain relievers equal in pain relief.

Maintaining a patient's airway, monitoring vital signs, assessing body systems (including surgical sites), ensuring patient safety, monitoring anesthetic effects, managing pain, accurately recording input and output, identifying readiness for discharge from the PACU, documenting care, and providing a bedside report to receiving nurses.

The process of determining if a patient has recovered sufficiently from anesthesia and surgery to be safely transferred to another unit.

A crucial communication between the PACU nurse and the receiving nurse, containing essential patient information (name, allergies, procedure, anesthesia type, status, oxygen, dressings, medications, post-op orders, history, family contact).

Involves ensuring a patent airway, utilizing airway maintenance techniques (e.g., jaw thrust), managing oxygen therapy as ordered, supporting deep breathing, promptly reporting respiratory depression, and positioning the patient on their side for airway protection when necessary, using suction as needed

Assessing the effective airway clearance and aspiration risk by verifying a patent airway, clear lung sounds, evaluating respiratory rate, ensuring absence of dyspnea, and proper ABGs.

Collecting data on cardiovascular status, including vital signs (heart rate, blood pressure), ECG, and skin assessments to identify trends and potential complications like hypotension, arrhythmias, and hypertension.

Clinical indications of hypovolemic shock include tachycardia, hypotension, pale skin, cool and clammy skin, and reduced urine output.

Checking the color and amount of drainage from surgical dressings and incisions to identify fluid imbalances and potential complications.

Monitoring a patient's fluid intake (input) and output to detect any imbalances (e.g., dehydration or fluid overload).

Ensuring that IV fluids are administered at the prescribed rate to replace lost fluids and prevent fluid overload.